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Tear in Esophagus
   
Mallory-Weiss Syndrome

[ Esophageal Tear ]

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This woman suffers from vertigo which causes her to have spells of nausea and vomiting. With her most recent attack, she vomited up her supper. Then, after more forceful retching, she began vomiting up large amounts of bright red blood. She was seen in our local emergency department and admitted to the hospital ICU. This photo was taken during an emergency gastroscopy performed by Dr. Richard Kim. It clearly shows a deep tear in the lower portion of her esophagus, or food pipe. This tear was caused by the forceful retching which sometimes "snaps" the lower esophagus much like a bull whip. To make matters worse, she was on a blood thinner called Coumadin which prevents clotting. This caused her to lose more blood. Fortunately, the bleeding stopped on its own and further treatment or surgery was not needed.

The medical term for this condition is Mallory-Weiss Syndrome. It is most often seen in men who binge drink, but can occur in anyone who vomits forcefully. The patient usually has one or more non-bloody vomiting episodes and then begins to bring up bright red blood. Usually the tear is at the junction of the esophagus and stomach as in this case. Most cases stop spontaneously. If the bleeding persists, it can often be controlled by injections or thermal cautery during the gastroscopy exam. In severe cases, major surgery is needed.

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